Radiographical Pathological Incidental Findings before Orthodontic Treatment

Abstract

Background and objectives: Panoramic as well as Cephalometric radiographs, in combination with a clinical examination, are regularly used as an aid and both are considered as a cornerstone for orthodontic diagnosis and treatment planning. Due to increasing numbers of patients seeking orthodontic treatment, an increase in incidental findings on diagnostic X-rays is suspected. The objective of this study was to determine the diverse incidental pathological findings observed in radiographs taken before orthodontic treatment in Al Baha Region, Saudi Arabia. Methods: This was a cross-sectional study that investigated 358 panoramic and Cephalometric radiographs who were randomly selected from the Orthodontics Department of Al-Baha University, Faculty of Dentistry Clinic in the period between 2019 and 2022. Only those pathological findings with a possible influence on orthodontic treatment were included and then compared with the patient's record. Results:The most common findings were thickening of mucosal lining in sinus maxillaries, multiple impacted teeth, dental anomalies and periapical inflammatory lesions. The majority of the periapical lesions and radiopacities were found in the mandible. Both the presence and the number of findings per patient increase with age but there is no association with sex P<0.001. Conclusion:The prevalence of incidental findings in this study was low especially those outside dental arches. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require urgent dental management. Careful radiographic examination in addition to use of advanced radiographic diagnostic methods are required to rule out significant pathological findings before orthodontic treatment.